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Research Article| Volume 367, P319-325, August 15, 2016

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Longitudinal changes in sickness absence and disability pension, and associations between disability pension and disease-specific and contextual factors and functioning, in people with multiple sclerosis

  • Charlotte Chruzander
    Affiliations
    Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE - 141 83 Stockholm, Sweden

    Department of Physiotherapy, Karolinska University Hospital, SE - 141 86 Stockholm, Sweden
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  • Petter Tinghög
    Affiliations
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE - 171 77 Stockholm, Sweden

    Red Cross University College, SE - 114 28 Stockholm, Sweden
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  • Charlotte Ytterberg
    Affiliations
    Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE - 141 83 Stockholm, Sweden

    Department of Physiotherapy, Karolinska University Hospital, SE - 141 86 Stockholm, Sweden
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  • Lotta Widén Holmqvist
    Affiliations
    Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE - 141 83 Stockholm, Sweden

    Department of Physiotherapy, Karolinska University Hospital, SE - 141 86 Stockholm, Sweden

    Division of Neuroscience, Department of Clinical Neuroscience, Karolinska Institutet, SE - 171 77 Stockholm, Sweden
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  • Kristina Alexanderson
    Affiliations
    Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE - 171 77 Stockholm, Sweden
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  • Jan Hillert
    Affiliations
    Division of Neuroscience, Department of Clinical Neuroscience, Karolinska Institutet, SE - 171 77 Stockholm, Sweden
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  • Sverker Johansson
    Correspondence
    Corresponding author at: Division of Neurology R54, Karolinska University Hospital, Huddinge, SE–141 86 Stockholm, Sweden. Tel.: +46 8 5177 2665; Fax: +46 8 5177 4967.
    Affiliations
    Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, SE - 141 83 Stockholm, Sweden

    Department of Physiotherapy, Karolinska University Hospital, SE - 141 86 Stockholm, Sweden
    Search for articles by this author

      Highlights

      • Over the MS trajectory work disability is a dynamic process.
      • The prevalence of sickness absence in early MS shifts later into disability pension.
      • Intervention development aiming at keeping people with MS in the work force is needed.
      • Factors such as manual dexterity should be targeted in such interventions.

      Abstract

      Background

      Even though it is well known that disability due to MS is highly associated with employment status, the long-term longitudinal perspective on sickness absence and disability pension over the MS trajectory is lacking. In addition, further knowledge of risk factors for future disability pension is needed.

      Objectives

      To explore long-term longitudinal changes in the prevalence of sickness absence and disability pension in people with MS (PwMS), as well as to explore associations between disease-specific factors, contextual factors and functioning, and the outcome of future full-time disability pension.

      Methods

      A prospective, population-based survival cohort study, with a nine year follow-up, including 114 PwMS was conducted by combining face-to-face collected data and register-based data.

      Results

      The prevalence of full-time disability pension increased from 20% to 50%, however 24% of the PwMS had no disability pension at all at end of follow-up. Sex, age, disease severity and impaired manual dexterity were associated with future full-time disability pension.

      Conclusions

      The large increase in prevalence of PwMS on full-time disability pension during the MS trajectory, calls for the development and implementation of evidence-based interventions, aiming at keeping PwMS in the work force. Modifiable factors, such as manual dexterity should be targeted in such interventions.

      Keywords

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